Analgesic Nephropathy

What is analgesic nephropathy?

An analgesic is any medicine intended to alleviate pain. Over-the-counter ( OTC) analgesics, among others, include the following:

Aspirin

Acetaminophen

Ibuprofen

Naproxen sodium

Taking one, or a combination of, these drugs regularly over a long period of time may increase the risk of kidney problems.

Analgesic nephropathy is a chronic kidney disease that gradually leads to end-stage renal disease and the need for permanent dialysis or a kidney transplant to restore renal function. It can result from taking painkillers every day for several years. And, the painkillers that combine two or more analgesics (for example, aspirin and acetaminophen together) with caffeine or codeine are the most likely to damage the kidneys.

Warning

People who take any painkillers on a regular basis should consult their doctors to make sure they are not causing damage to their kidneys.

In addition, patients with conditions that put them at risk for acute kidney failure should consult their doctors before taking any medications (over-the-counter or prescription).

What are the symptoms of analgesic nephropathy?

The following are the most common symptoms of analgesic nephropathy. However, each individual may experience symptoms differently. Symptoms may include:

Fatigue or weakness

Blood in the urine

An increase in urination frequency or urgency

Pain in the back or flank area (where the kidneys are located)

A decrease in urine output

Decreased alertness, such as drowsiness, confusion/delirium, or lethargy

Decreased sensation or numbness, especially in the extremities

Nausea, vomiting

Generalized swelling

Easy bruising or bleeding

Some patients experience no symptoms and kidney damage is picked up by routine blood tests. The symptoms of analgesic nephropathy may resemble other medical conditions or problems. Always consult your doctor for a diagnosis.

How is analgesic nephropathy diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for analgesic nephropathy may include the following:

Blood pressure measurement

Urine toxicology screen

Urinalysis. Laboratory examination of urine for various cells and chemicals, such as red blood cells, white blood cells, infection, or excessive protein.

Complete blood count. A measurement of size, number, and maturity of the different blood cells in a specific volume of blood.

Examination of any tissue passed in the urine

Intravenous pyelogram. A series of X-rays of the kidney, ureters, and bladder with the injection of a contrast dye into the vein to detect tumors, abnormalities, kidney stones, or any obstructions, and to assess renal blood flow.

What is the treatment for analgesic nephropathy?

Specific treatment for analgesic nephropathy will be determined by your doctor based on:

Your age, overall health, and medical history

Extent of the disease

Your tolerance for specific medications, procedures, or therapies

Expectations for the course of the disease

Your opinion or preference

Treatment may include:

Discontinuation of all suspect analgesics, especially OTC medications

Dietary modifications

Medication

Behavioral modification or counseling as an alternative method of chronic pain control

Treatment focuses on preventing any further kidney damage, and treatment of any existing kidney failure.

What is acute kidney failure?

Some reports have attributed incidents of acute kidney failure to the use of painkillers, including aspirin, ibuprofen, and naproxen. Many of the patients in these reports had risk factors, such as the following:

Systemic lupus erythematosus (lupus)

Advanced age

Chronic renal conditions

A recent binge of alcohol consumption

Consult your doctor for more information about diagnosis and treatment of analgesic nephropathy and acute kidney failure.